Keto resources for mental health and psychiatry

chart depicting keto resources overview - Keto for PsychContents. Keto resources for psych. Keto Books. Building my team. Medical professionals. Caregivers & patients. Keto Community. Guidelines.  Keto doctors near me.

Finding the best keto resources for mental health and psychiatry is challenging. This week we’re bringing you the help you’ve been asking for. People suffering from treatment-resistant mental illnesses will need their healthcare professionals’ support. We want to help. For this reason we’ve compiled valuable ketogenic diet sources to share with your medical team. If we missed something please let us know in the comments.

Keto for psych resources? Start with pediatric epilepsy

The most rigorous studies on the ketogenic diet come from the pediatric epilepsy literature. Almost every treatment used for epilepsy is also used in psychiatry to treat  a broad range of conditions. These include depression, anxiety, schizophrenia, and bipolar disorder. (1)

For treatment-resistant cases, mental health professionals may find this diet especially useful. In fact, this diet can be considered a proven treatment for epilepsy being used “off label” for a psychiatric condition.

Off-label prescriptions

As most mental health professionals already know, “off-label” use of epilepsy medications is commonplace in psychiatry. “Off-label” medication use refers to the practice of prescribing a drug for a disorder other than the one for which it was FDA approved. Therefore, if a drug is approved for epilepsy and is later found to be helpful for bipolar-disorder, it is then prescribed as an “off-label” treatment for bipolar. Also, the FDA approval process often does not test drug combinations.  As a result, any time a patient is taking more than one medication, the prescription combination is likely “off-label” as well. In many ways, using the medical ketogenic diet as a treatment is no different. It is accepted for use in epilepsy and is helpful for several psychiatric disorders. Examples of off-label epilepsy medication use in psychiatry are many. For instance, commonly prescribed drugs such as: lamotrigine, depakote, and ativan.

Publications

Pediatric epilepsy foundations focused on ketogenic dietary therapies

Building my team

Please read our companion post on using the ketogenic diet for mental health issues.  It may surprise you.  Here are Unfortunately, there are very few Keto for Psych providers. We hope to one day answer the question: Is there a ketogenic mental health clinician for psych near me? For now, we can offer this general list:

Keto doctors near me

Low carb doctors near me.

Keto telemedicine providers are filling the gap

Intensive Dietary Management (IDM Program)

Their tag line is “Fasting for weight-loss and diabetes control made simple.”

IDM’s clinic has treated over 14,000 patients as of July, 2019. (5) Founded in 2012, Dr. Jason Fung and Megan Ramos focus on fasting. Dr. Fung has found that fasting, paired with a low carbohydrate, high fat diet, works best for weight loss. For the insulin-resistant or metabolically-challenged, they pair fasting with a ketogenic diet. Yet, in their fasting program you’re free to use whatever diet you choose. Based in Toronto, Canada, IDM supports a very culturally-diverse population. Many of them fast for religious reasons. This includes many Indian vegetarians, like my sister-in-law.

Virta Health: Clinically-proven treatment for diabetes reversal

While Virta’s current protocol focuses on diabetes reversal, anyone can apply.  Insurance (e.g., Kaiser Permanente) may cover your treatment. Currently, the treatment protocol which their dietitians focus on is diabetes centric.

Resources for medical professionals

Keto for mental health and psych

Ketogenic dietary therapies for pediatric epilepsy & type 2 diabetes

Low carb and keto diet for weight loss

Note: A medical ketogenic diet is stricter than a ketogenic diet for weight loss. Low carb diets are the lest strict still.

Keto resources for families, caregivers and patients

Keto for psych podcasts with Chris Palmer, MD.

While titles are similar, each podcast includes new information. (Show notes will come)

Ketogenic diet overviews

Guidelines are emerging

Different diet versions are emerging to treat different disorders, including being overweight and obesity, type 2 diabetes, and pediatric epilepsy. While it is too new for its own guidelines to have been developed, here is what we know about the medical ketogenic diet for psychiatric disorders.

Of course there are many websites, books, podcasts and self-proclaimed experts. Buyer beware.

Moderated groups for individuals and their families

There are not (yet) any moderated groups focused on keto for mental health.   The following are popular forums for ketogenic eating.

Free

With membership (some have a free trial period).

Other useful ketogenic diet resources

This keto book list is ordered by a measure of popularity, the number of ratings received on Goodreads.

Low carb and keto books for beginners

More advanced low carb and keto books

Low carb and keto articles

Anne Mullens and Georgia Ede, M.D. Ketogenic diet for mental health: Come for the weight loss, stay for the mental health benefits? Diet Doctor. June, 2019.

Georgia Ede, M.D.

More to come

Books, podcasts and blogs.  We, along with many others are starting to cover Keto for Psych topics.  We’ll be adding more here soon.  Suggestions welcome!

You may need to pay for quality information

If someone doing keto for weight loss eats the wrong thing, then their weight loss stalls. No big deal. In contrast, if someone doing keto as treatment for brain disorder makes a mistake, then dangerous symptoms could return. This is a very big deal. This symptom relapse might include seizures, psychosis, or suicidal ideations. Please proceed carefully with this prescription-strength intervention, for it has both potent potential benefits as well as dangers. It is just like any other strong medical intervention.

With the Internet, consumers have become accustomed to information being free. But in this case hiring professionals to guide you in this high-stakes endeavor makes sense. Although we have nothing to sell and can not see patients, we recommend collaboration with clinicians well-versed in this treatment. An expert clinician can tailor the medical ketogenic diet to your individual circumstances.

Building my own keto treatment team

The current reality of this cutting-edge therapy may be that a patient needs to build their own team. Patients will benefit by having both excellent psychiatric care and careful ketogenic guidance. For example, an open-minded psychiatrist, could partner with a clinician experienced in ketogenic-dietary intervention.

Start with a competent mental health care provider interested in trying the ketogenic dietary therapy.

Roles on my keto treatment team.

Some or all of these roles could be provided by the same person.

Competent, interested mental-health provider.

Families should start here.  Perhaps your current clinician is interested in trying a ketogenic dietary therapy?  Many professionals are already frustrated with the high percentage of treatment-resistant patients they see.

Ketogenic clinician.

This could be a physician, including a primary care doctor.  It could also be a registered dietitian. By defining team roles we are hoping that keto-experienced clinicians can reach more patients in need.  Their consultations might focus on other professionals as they “train the trainers.”

Prescriber.

If you are on any prescription medications then your team must include a prescriber licensed in your state. Frequently this is either the mental health provider or the clinician described above.  Licenses might include MD or APN. Your medications are likely to change frequently, especially in the first 12 weeks. For example, both lithium and the ketogenic diet dehydrate you. While not a contraindication, medications and potential side effects need to be managed carefully. Otherwise things can get dangerous quickly.

Keto Coach.

They would need to be familiar with the time, effort and social challenges involved.  At this time there is no universally respected certification process. As a result, many of varying expertise may offer this service.

Ketogenic Food Service Provider.

While there may be many who want to perform this service, be warned that many are not prepared to offer a medical ketogenic diet. Food services are not licensed clinicians and are not likely to know the intricacies of dietary interventions.  For instance, a service that successfully helped people use the ketogenic diet for weight loss, might have difficulty getting a thin, athletic, psychiatric patient into ketosis. Metabolic differences and different levels of ketosis require different ketogenic diet structures. On a medical ketogenic diet you can’t just limit carbohydrates to 20g a day.  In fact, you must calculate macros and ensure that the patient is having enough fat. Also be aware of and able to intervene with several potential adverse events. These can vary from an electrolyte imbalance to nutritional deficiency to muscle loss.

Demand and supply of experienced clinicians

There is also clear demand for clinician-led caregiver-support groups and keto-friendly in-patient services. While these services do not yet exist, we are hopeful that they will soon. We will provide more information on building your team in an upcoming post.

Sadly, the Heal Clinic, a subscription-based ketogenic-dietary clinic, recently folded. They said they realized their business model was flawed.  Maybe this is related to the expectation of free information provided by a quick web search.

How did we decide who to include?

Those with treatment-resistant mental illness benefit from the support and guidance  of their medical team. As a result, our criteria in deciding which resources to include was the following. “What will convince mental health clinicians, general practitioners, or a medical director use this potentially-potent intervention?”

If you are a ketogenic-healthcare provider willing to see psychiatric patients then we would love to include you in our up-coming directory!  Drop us (Nurse Christie & Cecile) a line at Team@ChrisPalmerMD.com.

Sources:

  1. Palmer, C. The Ketogenic Diet May Help Stop Seizures: This dietary treatment based on ancient medicine is making a comeback. Psychology Today. Posted Mar 26, 2019
  2. Kossoff, EH, et al. Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group [Pubmed Abstract]. [Full Text HTML]. [Full Text PDF]. Epilepsia Open. 2018 May 21;3(2):175-192. doi: 10.1002/epi4.12225. eCollection 2018 Jun.
  3. Kosoff, EH. Ketogenic and Modified Atkins Diets, 6th Edition: Treatments for Epilepsy and Other Disorders. Demos Medical Publishing. March 1st 2015.
  4. deCampo DM, Kossoff EH. Ketogenic dietary therapies for epilepsy and beyond. Current Opinion in Clinical Nutrition and Metabolic Care. 2019 Jul;22(4):264-268. doi: 10.1097/MCO.0000000000000565.
  5. Megan Ramos’s presentation on Fasting Friday at Ketofest 2019. July 19, 2019.

Cecile Seth

Cecile Seth, MBA. Journalist. Co-Founder. Harvard Business School. Wellesley College. Bain & Company. Ms. Seth's award-winning blog, STEMshoots, helps her suburb with community planning and strengthening its schools.

4 Responses

  1. Carroll says:

    Ken Berry … How to find a Low-Carb/KETO Doctor (Doctors who Get It-2019)
    https://www.youtube.com/watch?v=lJ0ZQEq3sbo
    New Doctor but 10 years into Carnivore ..
    Starting up in San Diego… Paul SaladinoMD
    boths with podcast

  2. Brie says:

    I’m a trained social worker disillusioned with the current mental healthcare system. I would definitely consider practicing as part of a keto team. Looking forward to more info on keto certifications and keto-centric clinics to work for!

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